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Kędzia-Berut R, Berut M, Włodarczyk M, Włodarczyk J, Dziki Ł, Dziki A, Mik M. Colorectal Cancer: Is it Still a Disease of the Elderly? POLISH JOURNAL OF SURGERY 2023; 96:41-45. [PMID: 38348978 DOI: 10.5604/01.3001.0054.0956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
<b><br>Introduction:</b> Colorectal cancer is becoming an increasingly significant health issue, being one of the more commonly diagnosed malignancies. Colorectal tumors account for 10% of all malignant cancers in women and 12% in men. Incidence is higher in the male population, especially among younger individuals. It is commonly believed that colorectal cancer is predominantly associated with advanced age. However, colorectal surgeons, who specialize in the treatment of this type of cancer, are observing a growing number of cases among middle-aged and younger individuals.</br> <b><br>Aim:</b> The aim of our study was to investigate whether colorectal cancer still predominantly affects elderly individuals, how frequently it is diagnosed in younger patients, and whether the location of tumors in the intestines of younger patients aligns with data from elderly individuals.</br> <b><br>Materials and methods:</b> The study was conducted retrospectively and included a cohort of 1771 patients who underwent surgical procedures due to colorectal cancer between 2012 and 2015 at the Department of General and Colorectal Surgery at the Medical University of Łódź and between 2014 and 2017 at the Department of General Surgery with a Division of Surgical Oncology at the District Health Center in Brzeziny. Data were analyzed regarding the frequency of colorectal cancer occurrence by age, tumor location in different age groups, and disease stage according to age. Age groups included <40 years, 41-50 years, 51-70 years, and >70 years.</br> <b><br>Results:</b> The study encompassed a total of 1771 patients, with 988 (55.79%) being males and 783 (44.21%) females. The mean age of the patients was 65.27 11.12 years. The highest number of cases was observed in the age range of 60-70 years and 70-80 years. It was found that colorectal tumors in males more frequently occurred on the left side of the colon and rectum, while in females, they were more commonly located on the right side of the colon, which was statistically significant (P = 0.007). Younger age groups of patients (<40 years, 40-50 years) had a similar male-to-female ratio, whereas in age groups above 50 years, males significantly outnumbered females (P = 0.049). The study revealed that in the group of patients below 40 years of age, an advanced stage of colorectal cancer was significantly more common; stage D occurred over twice as often as in the 51-70 age group and over three times as often as in the >70 age group.</br> <b><br>Conclusions:</b> The incidence of colorectal cancer in Poland is steadily increasing, with a growing number of diagnoses in younger individuals. Research findings demonstrate that males, especially those in younger age groups, are at a higher risk of developing colorectal cancer. A higher disease stage is more frequently observed in younger patients, possibly due to delayed diagnosis and symptomatic treatment. Screening programs should be adjusted to the changing age groups at higher risk. Our study underlines the need to raise public awareness regarding colorectal cancer, particularly among the younger population.</br>.
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Affiliation(s)
- Renata Kędzia-Berut
- Department of General and Colorectal Surgery, Military Medical Academy Memorial Teaching Hospital, Lodz, Poland
| | - Maciej Berut
- Department of General Surgery with Subdivision of Oncological Surgery, District Health Center in Brzeziny, Poland
| | - Marcin Włodarczyk
- Department of General and Cancer Surgery, Central Clinical Hospital of the Medical University of Lodz, Poland
| | - Jakub Włodarczyk
- Department of General and Cancer Surgery, Central Clinical Hospital of the Medical University of Lodz, Poland
| | - Łukasz Dziki
- Department of General and Cancer Surgery, Central Clinical Hospital of the Medical University of Lodz, Poland
| | - Adam Dziki
- Department of General and Colorectal Surgery, Military Medical Academy Memorial Teaching Hospital, Lodz, Poland
| | - Michał Mik
- Department of General and Colorectal Surgery, Military Medical Academy Memorial Teaching Hospital, Lodz, Poland
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Saghatchian M, Thonon F, Boomsma F, Hummel H, Koot B, Harrison C, Rajan A, de Valeriola D, Otter R, Laranja Pontes J, Lombardo C, McGrath E, Ringborg U, Tursz T, van Harten W. Pioneering quality assessment in European cancer centers: a data analysis of the organization for European cancer institutes accreditation and designation program. J Oncol Pract 2014; 10:e342-9. [PMID: 25118210 DOI: 10.1200/jop.2013.001331] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In order to improve the quality of care in Cancer Centers (CC) and designate Comprehensive Cancer Centers (CCCs), the Organization for European Cancer Institutes (OECI) launched an Accreditation and Designation (A&D) program. The program facilitates the collection of defined data and the assessment of cancer center quality. This study analyzes the results of the first 10 European centers that entered the program. METHODS The assessment included 927 items divided across qualitative and quantitative questionnaires. Data collected during self-assessment and peer-review from the 10 first participating centers were combined in a database for comparative analysis using simple statistics. Quantitative and qualitative results were validated by auditors during the peer review visits. RESULTS Volumes of various functions and activities dedicated to care, research, and education varied widely among centers. There were no significant differences in resources for radiology, radiotherapy, pathologic diagnostic, and surgery. Differences were observed in the use of clinical pathways but not for the practices of holding multidisciplinary team meetings and conforming to guidelines. Regarding human resources, main differences were in the composition and number of supportive care and research staff. All 10 centers applied as CCCs; five obtained the label, and five were designated as CCs. CONCLUSION The OECI A&D program allows comparisons between centers with regard to management, research, care, education, and designation as CCs or CCCs. Through the peer review system, recommendations for improvements are given. Assessing the added value of the program, as well as research and patient treatment outcomes, is the next step.
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Affiliation(s)
- Mahasti Saghatchian
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Frédérique Thonon
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Femke Boomsma
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Henk Hummel
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Bert Koot
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Chris Harrison
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Abinaya Rajan
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Dominique de Valeriola
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Renée Otter
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - José Laranja Pontes
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Claudio Lombardo
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Eoin McGrath
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Ulrik Ringborg
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Thomas Tursz
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
| | - Wim van Harten
- Institut Gustave Roussy, Villejuif, France; Integraal Kankercentruum Nederland, Grongingen; Compusense, Voorhout; Netherlands Cancer Institute, Amsterdam, the Netherlands; Imperial College Healthcare NHS Trust, London, United Kingdom; Institut Jules Bordet; Organisation of European Cancer Institutes, Brussels, Belgium; Instituto Português de Oncologia do Porto, Porto, Portugal; European Group for Blood and Marrow Transplantation, Barcelona, Spain; and Karolinska Institutet, Stockholm, Sweden
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van de Velde CJH, Boelens PG, Tanis PJ, Espin E, Mroczkowski P, Naredi P, Pahlman L, Ortiz H, Rutten HJ, Breugom AJ, Smith JJ, Wibe A, Wiggers T, Valentini V. Experts reviews of the multidisciplinary consensus conference colon and rectal cancer 2012: science, opinions and experiences from the experts of surgery. Eur J Surg Oncol 2013; 40:454-68. [PMID: 24268926 DOI: 10.1016/j.ejso.2013.10.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 10/23/2013] [Indexed: 12/12/2022] Open
Abstract
The first multidisciplinary consensus conference on colon and rectal cancer was held in December 2012, achieving a majority of consensus for diagnostic and treatment decisions using the Delphi Method. This article will give a critical appraisal of the topics discussed during the meeting and in the consensus document by well-known leaders in surgery that were involved in this multidisciplinary consensus process. Scientific evidence, experience and opinions are collected to support multidisciplinary teams (MDT) with arguments for medical decision-making in diagnosis, staging and treatment strategies for patients with colon or rectal cancer. Surgery is the cornerstone of curative treatment for colon and rectal cancer. Standardizing treatment is an effective instrument to improve outcome of multidisciplinary cancer care for patients with colon and rectal cancer. In this article, a review of the following focuses; Perioperative care, age and colorectal surgery, obstructive colorectal cancer, stenting, surgical anatomical considerations, total mesorectal excision (TME) surgery and training, surgical considerations for locally advanced rectal cancer (LARC) and local recurrent rectal cancer (LRRC), surgery in stage IV colorectal cancer, definitions of quality of surgery, transanal endoscopic microsurgery (TEM), laparoscopic colon and rectal surgery, preoperative radiotherapy and chemoradiotherapy, and how about functional outcome after surgery?
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Affiliation(s)
- C J H van de Velde
- Department of Surgery, Leiden University Medical Center, The Netherlands.
| | - P G Boelens
- Department of Surgery, Leiden University Medical Center, The Netherlands.
| | - P J Tanis
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - E Espin
- Colorectal Surgery Unit, Hospital Valle de Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - P Mroczkowski
- Department of General, Visceral and Vascular Surgery/An-Institute for Quality Assurance in Operative Medicine, Otto-von-Guericke University of Magdeburg, Germany
| | - P Naredi
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - L Pahlman
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - H Ortiz
- Department of Surgery, Public University of Navarra, Spain
| | - H J Rutten
- Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - A J Breugom
- Department of Surgery, Leiden University Medical Center, The Netherlands
| | - J J Smith
- Department of Colorectal Surgery, West Middlesex University Hospital, Isleworth, UK
| | - A Wibe
- Department of Surgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - T Wiggers
- Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - V Valentini
- Unviersita Cattolica S. Cuore, Radioterapia 1, Largo A. Gemelli, 8, 00168 Rome, Italy
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Pramateftakis MG, Raptis D, Kanellos D, Christoforidis E, Tsoulfas G, Kanellos I, Lazaridis C. Abdominoperineal resection for rectal cancer: is the pelvic drain externalization site an independent risk factor for perineal wound healing? Int J Surg Oncol 2012; 2012:156935. [PMID: 22611493 PMCID: PMC3352578 DOI: 10.1155/2012/156935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 02/14/2012] [Indexed: 02/05/2023] Open
Abstract
Aim. The aim of this paper is to investigate if the insertion of the pelvic drainage tube via the perineal wound could be considered as an independent risk factor for perineal healing disorders, after abdominoperineal resection for rectal malignancy. Patients and Methods. The last two decades, 75 patients underwent elective abdominoperineal resection for malignancy. In 42 patients (56%), the pelvic drain catheter was inserted through the perineal wound (PW group), while in the remaining 33 (44%) through a puncture skin wound of the perineum (SW group). Patients' data with respect to age (P = 0.136), stage (P > 0.05), sex (P = 0.188) and comorbidity (P = 0.128) were similar in both groups. 25 patients (PW versus SW: 8 versus 17, P = 0.0026) underwent neoadjuvant radio/chemotherapy. Results. The overall morbidity rate was 36%, but a significant increase was revealed in PW group (52.4% versus 9%, P = 0.0007). In 33.3% of the patients in the PW group, perineal healing was delayed, while in the SW group, no delay was noted. Perineal healing disorders were revealed as the main source of increased morbidity in this group. Conclusion. The insertion of the pelvic drain tube through the perineal wound should be considered as an independent risk factor predisposing to perineal healing disorders.
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Affiliation(s)
- M. G. Pramateftakis
- 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, Exochi, 57010 Thessaloniki, Greece
| | - D. Raptis
- 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, Exochi, 57010 Thessaloniki, Greece
| | - D. Kanellos
- Surgical Department, European Medical Center, Pilea, 55236 Thessaloniki, Greece
| | - E. Christoforidis
- 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, Exochi, 57010 Thessaloniki, Greece
| | - G. Tsoulfas
- Surgical Department, European Medical Center, Pilea, 55236 Thessaloniki, Greece
| | - I. Kanellos
- 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, Exochi, 57010 Thessaloniki, Greece
- Surgical Department, European Medical Center, Pilea, 55236 Thessaloniki, Greece
| | - Ch. Lazaridis
- 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, Exochi, 57010 Thessaloniki, Greece
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